Benefits Verification Specialist

State of Maryland•Baltimore County, MD

13h•Onsite

About The Position

The Subsequent Injury Fund (SIF) reviews and investigates workers' compensation claims that involve pre-existing health conditions that substantially increase the disability of injured workers. The liability of employers' insurers is limited to compensation for the damages caused by the current injury, and the SIF incurs all additional liability from the combined effects of all injuries and/or conditions. The Subsequent Injury Fund is seeking a Benefits Verification Specialist for the Claims Department. GRADE 12 LOCATION OF POSITION Baltimore County 222 Schilling Circle, Suite 180 Hunt Valley, Maryland 21031

Requirements

Education: Graduation from an accredited high school or possession of a high school equivalency certificate.
Experience: Two years of experience performing administrative staff, clerical, clerical technical, or secretarial work.
Candidates may substitute 30 college credit hours from an accredited college or university for each year of the required experience.
Candidates may substitute U.S. Armed Forces military service experience as a non-commissioned officer involving staff work requiring regular use of independent judgment and analysis in applying and interpreting rules and regulations in accordance with agency laws and policies on a year-for-year basis for the required experience.

Nice To Haves

Experience in the calculation and preparation of benefit payment memorandums
Experience in computerized case control systems including diary notation and document generation
Professional writing and oral communication skills

Responsibilities

Read, analyze and accurately interpret MD Workers' Compensation Commission (WCC) awards involving Subsequent Injury Fund (SIF) fiscal liability.
Check awards for accuracy.
Consult with WCC Commissioner assistants to resolve issues regarding WCC Award calculation errors effecting SIF liability amount and payment onset dates, disputed SIF legal and medical fee liability payments and SIF credits for prior awards.
Consult with SIF Assistant Attorney’s General to resolve WCC Award and Final Compromise and Settlement Agreement Award language confusion regarding SIF liability payment dates and dollar amounts.
Consult with insurance company claims adjusters to resolve payment calculation disputes regarding SIF payment liability onset dates.
Check accuracy of addresses using 2 different sources.
Accurately calculate SIF payment onset date.
Utilizing one of eleven templates, prepare a payment memorandum to the SIF Fiscal Unit detailing overall SIF liability, payment start date, biweekly payment amount, fee payments and amount and length of biweekly payment reduction (if applicable).
In cases of Settlement Agreements, list if S/A is in lieu of an award, whether there are credits/no credits for any award amount already paid and check the accuracy of any attorney’s fees.
Utilize a warning report, pull files for start claimant payments.
Verify start pay amount, biweekly amount, start date, award date, and balance of SIF liability (weekly).
Send start pay letter to claimant and claimant’s attorney along with direct deposit form and instructions.
Utilize a warning report, send end pay letter to claimant and claimant’s attorney once balance drops below the biweekly rate (biweekly basis).
Present case summaries and recommendations at the weekly Subsequent Injury Fund Board meetings in response to lump sum payment applications submitted by injured workers receiving biweekly payments from the SIF.
Provide signature authorization to the Fiscal Unit for the accounting allocation of additional funds to the individual accounts of permanent total disability lifetime benefit recipients.
Prepare SIF Board Meeting Agenda and Meeting Minutes in Administrative Specialist II’s absence.
Distribute Settlement/Appeal Reviews and pertinent Workers’ Compensation Commission Awards to all pertinent personnel and enter Board decisions into the Word Meeting Minutes document and Time/Matters case control system post weekly Board meetings.
Check non-assessed assessments for accuracy on a weekly basis.
Respond to inquiries from claimants, attorneys (including SIF attorneys) and claims adjusters regarding claim payments, address changes, forms and letters on a routine, daily basis, and resolve any issues that may arise.
Monitor e-notices inbox for incoming WCC correspondence.
Open, date stamp and accurately associate incoming correspondence with correct claim the day of receipt.
Scan WCC Awards to TimeMatters case control system and match to corresponding files for delivery to Lead Attorney
In last name alphabetical order, accurately return claim folders to filing cabinets.
Accurately scan processing of designated closed claims documents within 48 hours of receipt.
Attach WCC hearing notices to corresponding claim files and distribute to attorneys.
Back-up telephone duty, answering incoming telephone calls & accurately transfer calls to the correct extension.
Serve as the Agency’s State Charity Campaign Coordinator.
Other duties as assigned.